Healthcare Provider Details

I. General information

NPI: 1922106921
Provider Name (Legal Business Name): RAMON V PRENDES RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

PO BOX 3213 26175 NW 142ND AVENUE
HIGH SPRINGS FL
32655-3213
US

V. Phone/Fax

Practice location:
  • Phone: 386-454-7771
  • Fax:
Mailing address:
  • Phone: 386-454-7771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT 568
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: